Individual provider Active NPI

David Rivera, PHYSICIAN ASSISTANT

  • Medical Physician Assistant
  • Bronx, NY
National Provider Identifier
1558417758
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
005652-1 Issued in NY
Practice address
3485 E Tremont Ave Ste 1B
Bronx, NY 10465-2016
Phone
(718) 828-1549
Fax
(718) 828-5029
NPI assigned
Jan 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 005652-1 NY Primary

Addresses

Primary practice location

3485 E Tremont Ave Ste 1B
Bronx, NY 10465-2016

Mailing address

108 Benson St
West Haverstraw, NY 10993-1305
Phone (845) 786-2622

Other names 1

  • Mr. David Rivera Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150225000046 NY Practitioner - Physician Assistant 8426374190 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
005652-1NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New York City Health and Hospitals Corporation CurrentSince May 7, 2021 Accepting new patients
New York City Health and Hospitals Corporation CurrentSince May 7, 2021 Accepting new patients
Hemant Patel MD PC Past Accepting new patients

Locations

2601 Ocean Pkwy
Brooklyn, NY 11235
Phone (718) 616-5354

8268 164th St
Jamaica, NY 11432
Phone (718) 883-2929

50 Water St
Fl 3
New York, NY 10004

506 Malcolm X Blvd
New York, NY 10037
Phone (212) 939-1000

215 W 125th St
Fl 2
New York, NY 10027
Phone (212) 491-2400

1901 1st Ave
New York, NY 10029
Phone (212) 230-6262

227 Madison St
New York, NY 10002
Phone (212) 238-7000

215 W 125th St
New York, NY 10027
Phone (212) 491-2400

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: drivera681687@nychhc.direct-ci.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1558417758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 BENSON ST",
            "city": "WEST HAVERSTRAW",
            "state": "NY",
            "postal_code": "109931305",
            "telephone_number": "845-786-2622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3485 E TREMONT AVE STE 1B",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104652016",
            "telephone_number": "718-828-1549",
            "fax_number": "718-828-5029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-28",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "005652-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "RIVERA",
            "prefix": "MR.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.